Publications by authors named "Tom J Spencer"

Objective: This study aimed to assess the feasibility of implementing Individual Placement and Support (IPS) with a focus on educational and employment goals, within a clinical service for the early detection of individuals at clinical high risk (CHR) of psychosis.

Method: Between June 2019 and April 2021, participants were recruited and received up to 6 (± 2) months support. : Enrolled participants, attended sessions, and disengagement rates were analyzed to assess feasibility.

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Background And Hypothesis: Mapping a patient's speech as a network has proved to be a useful way of understanding formal thought disorder in psychosis. However, to date, graph theory tools have not explicitly modelled the semantic content of speech, which is altered in psychosis.

Study Design: We developed an algorithm, "netts," to map the semantic content of speech as a network, then applied netts to construct semantic speech networks for a general population sample (N = 436), and a clinical sample comprising patients with first episode psychosis (FEP), people at clinical high risk of psychosis (CHR-P), and healthy controls (total N = 53).

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Introduction: Indicated primary prevention of psychosis is recommended by NICE clinical guidelines, but implementation research on Clinical High Risk for Psychosis (CHR-P) services is limited.

Methods: Electronic audit of CHR-P services in England, conducted between June and September 2021, addressing core implementation domains: service configuration, detection of at-risk individuals, prognostic assessment, clinical care, clinical research, and implementation challenges, complemented by comparative analyses across service model. Descriptive statistics, Fisher's exact test and Mann-Whitney -tests were employed.

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Recent work has suggested that disorganised speech might be a powerful predictor of later psychotic illness in clinical high risk subjects. To that end, several automated measures to quantify disorganisation of transcribed speech have been proposed. However, it remains unclear which measures are most strongly associated with psychosis, how different measures are related to each other and what the best strategies are to collect speech data from participants.

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Article Synopsis
  • The study analyzed neuroanatomical differences in healthy individuals with varying levels of schizotypy, a personality trait linked to psychosis risk, using data from over 3,000 participants globally.
  • Researchers discovered that individuals with higher schizotypy had thicker areas in the medial orbitofrontal/ventromedial prefrontal cortex (mOFC/vmPFC).
  • The findings indicate that there are distinct neuroanatomical patterns correlated with schizotypy and underscore its similarity with changes observed in schizophrenia, suggesting a potential continuum between normal and psychotic states.
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Background: Formal thought disorder is a cardinal feature of psychotic disorders, and is also evident in subtle forms before psychosis onset in individuals at clinical high-risk for psychosis (CHR-P). Assessing speech output or assessing expressive language with speech as the medium at this stage may be particularly useful in predicting later transition to psychosis.

Method: Speech samples were acquired through administration of the Thought and Language Index (TLI) in 24 CHR-P participants, 16 people with first-episode psychosis (FEP) and 13 healthy controls.

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Clinical services for the early detection of individuals at clinical high risk of psychosis, such as Outreach and Support in South-London (OASIS), have been successful in providing psychological intervention and psychosocial support to young people experiencing emerging signs of serious mental disorders. Despite this, several studies have repeatedly shown that vocational and functional recovery in the clinical high risk for psychosis population is still low. This study aimed at evaluating the presence and nature of educational and employment focused interventions within the OASIS service, in order to inform research and clinical interventions aimed at supporting young people with early signs of psychosis on their path to vocational recovery.

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The empirical success of the Clinical High Risk for Psychosis (CHR-P) paradigm is determined by the concurrent integration of efficient detection of cases at-risk, accurate prognosis, and effective preventive treatment within specialized clinical services. The characteristics of the CHR-P services are relatively under-investigated. A Pan-London Network for psychosis prevention (PNP) was created across urban CHR-P services.

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Correlative evidence suggests that testosterone promotes dominance and aggression. However, causal evidence is scarce and offers mixed results. To investigate this relationship, we administered testosterone for 48h to 41 healthy young adult men in a within-subjects, double-blind placebo-controlled balanced crossover design.

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Functional magnetic resonance imaging (fMRI) studies have implicated the left prefrontal cortex in priming. We tested the hypothesis that object encoding activity in different prefrontal cortex regions selectively predicts subsequent object priming and recognition respectively. Participants were scanned whilst making semantic category judgements about novel object pictures.

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In recognition memory tests, feelings of familiarity for stimuli vary in strength. Increasing levels of felt familiarity should modulate activity in brain structures that mediate familiarity memory. We used this expectation to identify the neural system that underlies scene familiarity memory.

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Activations produced by the recall of episodic and semantic memories differing in spatial content and age were examined. Recall of recent episodic memories with differing spatial content activated the medial temporal lobes and the retrosplenial-posterior cingulate cortex-precuneus complex more than recall of recent semantic memories with similarly differing spatial content. Some of these differences related to the amount of spatial information recalled because spatially richer recent memories, regardless of whether they were episodic or semantic, activated the right posterior parahippocampal cortex, precuneus, and posterior parietal cortex more.

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